Targeted acupuncture may offer women with major depression a safe and effective alternative to antidepressant medication, new research suggests.

Investigators at Stanford University School of Medicine in California found that women with major depressive disorder treated with depression-specific acupuncture had a 63% response rate after 12 sessions compared with a 44.3% response rate in 2 combined control groups who were treated with either acupuncture not known to help alleviate depressive symptoms or Swedish massage.

"Pregnancy just by its nature can bring out some underlying psychiatric and emotional issues ... but treatment of depression during pregnancy is critically important so that a woman can maintain her sense of well being and take good care of herself, her fetus and, someday, her child," study coauthor Deirdre Lyell, MD, Stanford University School of Medicine, said in a statement.

Led by Rachel Manber, PhD, the study was published in the March issue of Obstetrics & Gynecology.

Response Rates Significantly Higher

For the study, investigators randomized 150 women whose pregnancies were between 12 and 30 weeks of gestation and who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for major depressive disorder and who scored at least 14 on the 17-item Hamilton Rating Scale for Depression.

Of the 141 women who eventually entered the study, 52 received depression-specific acupuncture, 49 received control acupuncture, and 49 others received Swedish massage.

Treatments were provided twice a week for the first 4 weeks and then weekly thereafter for 4 additional weeks, with each session lasting about 25 minutes.

The investigators found that response rates were significantly higher in women who received depression-specific acupuncture than for either control group. Response rates in women randomized to the 2 control interventions did not differ significantly from each other at 37.5% for the control acupuncture group vs 50% for the massage group.

On the other hand, remission rates did not differ significantly between women who received depression-specific acupuncture at 34.8% and the combined control groups at 29.5%. They also did not differ between those assigned to the control acupuncture group at 27.5% or the massage group at 31.2%.

Thirty-three of the study participants discontinued treatment before the study endpoint, 30% of them for reasons related to the pregnancy. Some women in both acupuncture groups reported transient discomfort at the point of needle insertion, and 1 woman experienced bleeding at the needle site.

Significantly fewer women who received massage reported any adverse effects compared with the 2 acupuncture groups.

Clinically Meaningful

The study authors point out that the benefits observed with depression-specific acupuncture can be considered "clinically meaningful" when assessed in a broader context of depression studies.

Although there are no randomized controlled trials of antidepressants being used during pregnancy, 1 randomized controlled trial found that interpersonal psychotherapy produced a 52% reduction in Hamilton Rating Scale for Depression scores and a 19% remission rate after 16 weeks of therapy, to which the currently study compares very favorably.

According to the study, antidepressant use during pregnancy doubled between 1999 and 2003, but many women are reluctant to take these medications because of safety concerns. In fact, in this particular study, 94% of the women involved expressed reluctance to take an antidepressant because of their pregnancy.

"Because theres this concern about medication among pregnant women and their physicians, its important to find an alternative," said Dr. Manber.

Results from this study therefore suggest that this standardized acupuncture protocol could be considered a "viable treatment option" for depression during pregnancy, the investigators conclude.

Michael Thase, MD, University of Pennsylvania School of Medicine, cautions that findings from this study are preliminary, although they suggest that depression-specific acupuncture may have value in major depressive disorder in this patient population.

On the other hand, another study assessing depression-specific acupuncture in a broader population of men and women with major depressive disorder failed to find a significant effect from the modality, so evidence supporting acupuncture for the treatment of major depressive disorder is not consistent.

"Still there is reason to be cautious when prescribing antidepressants in pregnancy, and one has to weigh the pros and cons of using an antidepressant on an individual basis, he told Medscape Psychiatry.

"If these promising findings are confirmed, it would be good to have another option to complement the focused forms of psychotherapy which are currently used for antenatal depression," he added.

The study was funded by the Agency for Healthcare Research and Quality. The study authors and Dr. Thase have disclosed no relevant financial relationships.

In the 1992 presidential
campaign, Bill Clinton was a heavy underdog to popular incumbent George H. W.
Bush. Bush was considered unbeatable due to foreign policy successes including
the end of the Cold War and routing Saddam Hussein in the first Gulf War. But
Bushs approval ratings, which had been in the 90 percent range, began to dip as
his campaign ignored the economic recession. Clintons campaign manager James
Carvilles now famous campaign slogan, "Its the economy stupid," helped turn
the tide and Bill Clinton became the forty-second American president.

Just like George Bushs 1992
presidential campaign, todays medical community continues to promote the
medical myths associated with cholesterol while ignoring the real cause of
cardiovascular disease, inflammation.

Conventional opinion and
current medical dogma holds that low cholesterol, especially low LDL
cholesterol, reduces the risk and incidence of heart disease and stroke. This
belief is so entrenched in the medical community that the FDA now approves drugs
to prevent heart disease, as it did with Zetia and Vytorin, solely on the
evidence that they lower LDL cholesterol levels. Zetia has never been proven to
reduce heart attacks, strokes or death. Statin drugs help reduce the risk of
heart attack and stroke for those whove already had a cardiac event (one
percent over placebo) but fail to reduce death in women, the elderly, men over
the age of 47, and in men without cardiovascular risk factors.

A 2006 study in The
Archives of Internal Medicine looked at seven trials of statin use in
nearly 43,000 patients, mostly middle-aged men without heart disease. In that
review, statins didnt lower mortality.

Nor did they in a study known
as Prosper, published in The Lancet in 2002, which studied statin use
in people seventy and older. Nor did they in a 2004 review in The Journal of
the American Medical Association, which looked at thirteen studies of
nearly 20,000 women, both healthy and with established heart disease.

Despite a growing voice of
reason, which became even louder after the recently released Enhance study, the
cholesterol zealots continue to view cardiovascular disease with tunnel vision.
This myopic vision fuels the cholesterol drug war which rages on as each
pharmaceutical company seeks to gain economic gain in the 40 billion dollar a
year lipid lowering drug market.

In an attempt to take on the
cholesterol Goliath, Pfizers Lipitor (10 billion dollars in sales annually),
Merck and Schering-Plough combined their cholesterol lowering drugs, Zocor and
Zetia, to form the "super drug" known as Vytorin. Vytorins goal was to lower
LDL cholesterol more than either drug could alone. Zetia lowers blood
cholesterol by blocking the absorption of dietary cholesterol from the
intestines. Zetia used alone is modestly effective in lowering LDL cholesterol
by approximately 17 percent. Zocor alone lowers LDL levels by 36 percentsimilar
to Lipitor.

The hope was that by lowering
LDL to dramatically low levels, Vytorin would do a better job of slowing the
accumulation of fatty plaques in the arteries. Vytorin did, in fact, reduce
LDLby a whopping 51 percent (similar to AstraZenecas Crestor).

However, the two-year
"Enhance" trial failed to prove that Vytorin is better than Zocor alone for
slowing plaque accumulation; instead atherosclerosis worsened in those taking
Vytorin.

Merck and Schering-Plough
suppressed this finding for twenty months.

The study results were not
revealed until the two drug companies were pressured into doing so by an article
in The New York Times and a Congressional inquiry. The marketers of
Vytorin said they had nothing to hide. Its hard to believe they werent just a
little reluctant to publish their highly anticipated study. The news that
Vytorin, which retails for $100 a month and did $2 billion in sales in 2007, was
clinically inferior (perhaps even dangerous) to generic simvastatin (statin),
costing less than $20 a month, obviously wasnt what stockholders wanted to
hear.

Merck and Schering-Plough are
running full-page ads daily in the Times and Wall Street
Journal, warning people not to be confused by a single study and to
continue taking Vytorin. The advice was backed by the American Heart
Association, which the Times reported receives nearly $2 million a year
from Merck/Schering-Plough Pharmaceuticals.

Other LDL lowering drugs have
bitten the dust in the last coupe of years as well.

Pfizers trial of its
much-anticipated drug torcetrapib, which raised HDL, the good cholesterol, and
lowered LDL, had to be stopped in 2006 because the drug caused heart attacks and
strokes.

Estrogen replacement therapy,
which is known to lower LDL cholesterol levels, failed to reduce the incidence
of heart attack and stroke in clinical studies.

Ok, if cholesterol lowering
isnt the answer for everyone, why do statins help people with existing heart
disease? Dr. James K. Liao of Brigham & Womens Hospital in Cambridge,
Massachusetts, has been investigating this question for over a decade. He
suspects that statins have other biological effects. His research shows that
statin drugs not only block cholesterol, but also an inflammation-generating
enzyme known as rho-kinase.

When Liao reduced the
rho-kinase levels in rats, they didnt get heart disease. "Cholesterol lowering
is not the reason for the benefit of statins," he concludes. Of course, there
are dozens of inflammatory chemicals that play a role in triggering
cardiovascular disease. Diet, health habits, our environment, even our
personality may initiate inflammatory chemicals that perpetuate cardiovascular
disease events.

Ralph Waldo Emerson once said,
"People see only what they are prepared to see." As the evidence about
inflammation and cardiovascular disease rises, will conventional medicine and
the public at large be prepared to see that its not about lowering cholesterol
but in reducing inflammation? Hopefully, "Its the inflammation, stupid," will
become a common slogan in the campaign to fight cardiovascular disease.

Rodger Murphree, D.C., has
been in private practice since 1990. He is the founder of, and past clinic
director for a large integrated medical practice, which was located on the
campus of Brookwood Hospital in Birmingham, Alabama. He is the author of
Treating and Beating Fibromyalgia
and Chronic Fatigue Syndrome, Heart Disease What Your Doctor Wont Tell You,
and Treating and Beating Anxiety and Depression with Orthomolecular
Medicine. He can be reached at www.treatingandbeating.com, by email at
drrodgerm@yahoo.com or 1-205-879-2383.

LIVE LOVE LAUGHEvery day can be filled with meaning. Take a moment, just the amount of time you need to take a deep breath and exhale slowly, to ask yourself what is my dream, and how will I get there from here?What can you stop doing or do differently to simplify your life and make it more meaningful? What is truly important to you? Do you give some time each week to your true priorities?Why not fill your life with love and laughter whenever you can? There is no greater gift than the gift of loving others. There is nothing wrong with taking some time for self-care too. Love your pet? Love walking out in nature? Make time for your passions and those things that add value to your life. Your body, mind and soul will thank you.Do you have a mission in life?Dream it. Think about it. Talk about it. Commit to it.

Its no secret chiropractic care
works wonders for many suffering from back, neck and spinal related problems.
However, many are unaware that chiropractic care also provides excellent results
in a number of non-spinal related conditions including those related to the
extremities. Manipulative treatments chiropractors often apply to the spine are
similarly used by chiropractors on the joints of the extremities including the
hip, knee, ankle, foot, hand, wrist, elbow and shoulder joints. Manipulation of
these joints involves a safe, controlled and specific force that is skillfully
applied in order to restore normal joint motion that in turn provides nutrients
to the joint, reducing inflammation and pain. Researchers recently conducted a
study to compare the outcomes of treating patients with shoulder complaints
with usual care from a general practitioner (medical doctor) both with and
without the additional care of manipulative therapy applied directly to the
shoulder girdle. At 12 weeks after initiating care, those receiving the
additional manipulative therapy had better outcomes related to shoulder pain,
neck pain. At 26 weeks, those receiving the additional manipulative therapy had
statistically superior outcomes in shoulder pain, shoulder mobility and
mobility of the neck. If youre suffering from extra-spinal problems such as
problems with the legs, hips or arms, call our office for an appointment to see
if safe, natural and effective chiropractic care might be the solution for you!

Older
patients with lower back pain are increasingly getting more complex and
costlier spinal fusion surgeries, resulting in higher rates of life-threatening
complications and increasing costs for the healthcare system, U.S. researchers
said on Tuesday. A study of records from the federal Medicare program for the
elderly and disabled between 2002 and 2007 revealed a 15-fold increase in the
rate of complex surgeries to treat spinal stenosis -- a common condition in the
elderly in which the spinal canal narrows, causing pain in the back and legs. And
while the number of overall procedures to treat this problem dipped during the
period, hospital charges for those surgeries rose by 40 percent on an
inflation-adjusted basis, Dr. Richard Deyo of the Oregon Health and Science
University in Portland and his colleagues reported in the Journal of the
American Medical Association. In a telephone interview Deyo said the trend in
part is related to the introduction of new technology, such as spinal cages and
special screws used to fuse vertebrae together. But
it also reflects savvy marketing by orthopedic device makers such as Stryker
Corp., Medtronic Inc. and Johnson & Johnson's DePuy unit, that has
convinced surgeons more complex surgery is better, Deyo said. Studies, however,
suggest complex spinal fusion surgeries offer little benefit over simpler
procedures for most patients, and increase the risk of complications. "It
is driving up the cost of care without much evidence that it is improving
care," Deyo said. A study last year published in JAMA found that the cost
of treating spine problems in the United States rose 65 percent in the past
decade to $85.9 billion a year, rivaling the economic burden of treating
cancer, which costs $89 billion. Yet, for all of the spending, they found
people with spine problems actually felt worse. Deyo's team studied three
specific surgical procedures for lumbar stenosis: decompression, in which part
of the vertebrae is removed to ease pressure on nerve roots; simple fusion, in
which one or two discs are fused together through an incision in the back or
abdomen; and complex fusion, in which more than 3 vertebrae are treated or the
surgery is done from both the back and front. Overall,
the procedure rate fell 1.4 percent during the study period, but rates of
complex fusion surgery increased from 1.3 per 100,000 patients to 19.9 per
100,000. "What happened was the most complex type of surgery increased
15-fold over that period of time, a far more rapid increase than we could
explain just on the basis of more severe disease," Deyo said. "What
we also found is these more complex operations are associated with a higher rate
of serious complications." Patients in the study who had a complex fusion
procedure had a nearly three times higher odds of a life-threatening
complication compared with those who only got decompression. And overall
hospital charges rose 40 percent in inflation-adjusted dollars, the team found.
Dr. Eugene Carragee of the Stanford University School of Medicine in California
said in a commentary that the study should remind patients, doctors and
insurance companies to carefully weigh the options for spinal surgery. "...
the efficacy of basic spinal techniques must be assessed carefully against the
plethora of unproven but financially attractive alternatives," Carragee
wrote, noting that "financial incentives and market forces do not favor
this careful assessment before technologies are widely adopted."

According to a newly released report in the
American Journal of Preventative Medicine, the number of Americans ending up in
the hospital due to overdoses from prescribed painkillers, sedatives and
tranquilizers is rising steeply. In just 8 years, 1999 to
2006, hospital admissions from prescription drug overdoses increased an
alarming 65 percent from 43,000 to 71,000. Another stunning statistic - Unintentional
prescription drug overdoses surpassed motor vehicle crashes as the leading
cause of unintentional injury death in 2005 for those 35 to 54 years of age.
There are many more jaw dropping statistics listed in the report that highlight
the dangers of many prescription drugs, especially those prescribed for the
purpose of reducing pain.

What if you could simply lose
weight by getting more sleep, would you be interested? Well, new research
indicates that this isnt too far off. Researchers have found those who dont
get adequate sleep actually consume more calories than those who do.
Researchers followed 12 healthy young men for two 48-hour sessions while recording
their sleep, calorie consumption and activity level. They found those who got 4
hours of sleep versus 8 hours of sleep actually consumed 22 percent more
calories. Thus, the lack of adequate sleep resulted in a significant increase in their caloric intake. Other studies have also found shorter sleep
duration is associated with higher body mass index but this is the first
to study the effects of sleep duration to calorie consumption in normal-weight
individuals.